Fear, Anxiety, & Paranoia|
Chapter 24: Psychedelic Information Theory
When considering the emotional forces that affect human behavior, none are more powerful than the reproductive drive (desire for sex) and self-preservation mechanism (the fear of death). These two ends of the human life cycle are the contextual poles through which we view every other facet of our selves. We are born in the act of sexual conception, we die when the body breaks down beyond its own usefulness. But between the archetypes of Cupid and the Grim Reaper a greater disparity cannot be found. Of all the deities, fates, and virtues that war for human control, Eros (Love) and Thanatos (Death) rule above them all. Avoiding death and finding love, those are the primary human motivators, and both are hard-wired activities. Our autonomic nervous system instinctively pushes us towards sexual pleasure and pulls us away from pain and mortal danger, and the organ which rules this moment-to-moment primal emotional response to love and danger is the amygdala.
Much has been written about the role of the amygdala in emotional salience, but the text I found to be most in-depth is Joseph LeDoux’s The Emotional Brain and his follow-up, The Synaptic Self. In both of these texts, LeDoux refers the amygdala as the “low road” of sensory processing, a simple organ that utilizes crude and fast pathways to instantly recognize threats or opportunities and act instinctively in response to either. The amygdala is a central player in human behavior, regulating both the fight-or-flight response as well as instinctive craving responses to potential food sources, wealth sources, and mates. The amygdala is not quite the all-consuming primal beast-brain that predates and lords over the logical neocortex, but if you add in the rest of the medial temporal lobe and all the glandular nuclei that produce and regulate stress and reward hormones (sometimes referred to as the limbic system), you’re getting close very close to the primal emotional core of mammalian consciousness. Although the amygdala is tiny (about the size and shape of an almond), it is centrally located at the front of the medial temporal lobe where it can efficiently handle direct connections between incoming sensations and salient patterns stored in long-term memory. The amygdala is essential in both the recognition of emotionally salient stimulus, the regulation of the behavioral response to that stimulus, as well as in the potentiation of long-term-memory imprinting. In other words, the amygdala instinctively remembers what we like and don’t like, and is wired to make us instinctively seek out the things we like and avoid the things we don’t like; no rational thinking necessary. Of course, the rational brain can overrule the emotional dominance of the amygdala and make behavioral decisions based on thoughtful logic, but the impressions and reactions we have to any stimuli come from the amygdala first, regulating our instinctive “gut” reaction to the world around us.
So, in terms of fear, paranoia and the whole host of emotions that fill in the spectrum between mild anxiety and mortal panic, the amygdala is almost certainly involved. So the germane question to this particular text remains: What effects do psychedelic drugs have on the amygdala?
From a strictly pharmacological standpoint, the amygdala has roughly one half the 5-HT2A receptor density and binding potential as the primary visual cortex (Forutan, et. al), which means that psychedelics are less likely to have a strong direct effect on the amygdala, but could still be expected to have some mild effect. However, a more interesting picture emerges when you view the amygdala from a circuit standpoint, and see exactly how many areas of the brain the amygdala is in direct or indirect feedback with. The amygdala is like tiny little anxiety/panic button at the operational nexus of a great deal of emotional processing power, and once the amygdala gets going there is a biophysical chain reaction of sensation that filters down throughout the entire corpus. Fear and exhilaration are simply different words for the sensation of the amygdala alerting the body to danger or opportunity, and these feelings infect infect the organism, it takes a few moments to shake off the rush.
Now imagine this panic button is pressed while under the influence of psychedelics. Since psychedelics amplify all thought and perception, even the slightest hint of fear will be instantly amplified in the neocortex, causing a self-perpetuating feedback loop of anxiety and paranoia. If the amygdala sends excited panic signals to an excited cortex, the excited cortex will construe that signal as a dire threat, and then re-stimulate the amygdala to deal with the emerging crisis, thus creating an excited feedback loop between the cortex and amygdala that gets exponentially stronger with each circuit iteration. When you add the increased awareness and resolution of all peripheral sensation into this particular feedback process, every creeping shadow or passing noise instantly becomes part of the larger ambiguous threat suddenly looming over you, the threat which is closing in on you at this very moment. Finally, when you layer in the brain’s capacity to “fill in the blanks” and fabricate objects and noises that aren’t there (also called “hallucinations”), the object of anxiety or paranoia can become instantly manifest in the imagination, and will seem in every way “real” to a subject under the influence of psychosis or paranoid hallucinations. Paranoia and panic are illogical by nature, and the panic process is purposely wired to be “runaway” in that it can become over-excited in dire circumstances and override all rational control. Of all the cognitive feedback pathways excited under the influence of psychedelics, the cortico-amygdalo anxiety, panic, and paranoia loop is obviously most troublesome. It is likely the common source of all paranoid freakouts under the influence of hallucinogens.
While anxiety produced by psychedelics may sometimes be in response to legitimate threats, more often than not tripping people become anxious and paranoid over things that are relatively minor if not completely fabricated. For example, I once went hiking while on a mild dose of LSD, and along the way somewhere I got a splinter in my palm. It was not a big splinter, but it was long and in under the skin in the middle of my palm. It hurt, and I could not get it out without tweezers or a small knife, neither of which I had. Although I could rationally tell myself that a small splinter would not kill me, and that I would be fine for half a day with a splinter in my palm, I could not help worrying about my hand all day long. I obsessively checked and re-checked the amount of redness and swelling around the splinter to see if it was getting infected. It also looked like it was right next to a large blood vessel under my skin, and I kept thinking that I needed to rush home to pull it out before bacteria got into my bloodstream, because if bacteria got into my bloodstream it could get into my heart, and if my heart got infected with bacteria I’d be dead. This was my reasoning. In reality the splinter was a minor nuisance, and normally I would have dismissed it, but in this instance it bothered me all day simply because it was a small nagging problem that could not be immediately resolved. Thus, the anxiety would not leave me alone.
As I hiked and tried to enjoy the day, I would find myself getting very worried and again obsessing over how to get that splinter out, and then I would finally convince myself that it was no big deal, and that I could safely leave it alone until I made it back home at the end of the day. But even though I could rationally convince myself that I was safe, the obsessive anxiety would recur every few minutes, and I would have to go back through the exact same mental rationalization over and over to keep my looming anxiety from spiraling out of control. I was literally stuck in a loop that started in pain and anxiety and exited into a maze of logical rationalizations, including the exact location of my tweezers in a drawer back home, so that I might bound into the house when I finally got home and instantly pluck the splinter from my reddening palm without a moment’s hesitation. This entire scenario repeated and fed back on itself in entirety (from pain in my hand to me visualizing myself bounding through the door of my house to grab the tweezers) every few minutes, over and over again, most of the day. There was the short-term pain biofeedback driving the anxiety spiral, but there was also long-term potentiation, repetition, and recursion of the same exact emotional and rational reactions echoing and growing stronger throughout the day.
The problem was that I simply could not forget the splinter. My excited amygdala continued to perceive this tiny laceration as a dire threat, even though I had rationally convinced myself otherwise. And the momentary paradox between feeling legitimate panic while simultaneously thinking that I might be overreacting is a very confusing place to be, especially when my cortex was chemically altered and having trouble staying focused on what was real and what was imaginary. This is almost the very definition of insanity itself, because it felt like at any moment the panic would take over and I would have to rush back to the car and drive home high on LSD just to remove a splinter from my hand. Although the problem was small, the enormity of how to deal with it almost overwhelmed me. Even though I was able to enjoy the rest of the day, drive home that evening, and finally pluck the bothersome splinter from my hand with little thought or consequence, it took a great deal of effort for me to keep that anxiety at bay for an entire day, particularly during the onset and early peak of the trip when everything seems heightened and strange to begin with.
The funny thing about the example with the splinter is that I have been in actual life-threatening situations under the influence of psychedelics, and the panic I felt was nowhere near as great as the panic I have felt on the few paranoid “freak outs” that I’ve experienced. Oddly, it seems that the more abstract, invisible, or unverifiable the perceived threat is, the more prone one is to slip into an anxiety spiral. For instance; in the case of my splinter I was more concerned about bacteria and infection than I was about the pain. I couldn’t see the bacteria, but I knew they were there and would infect my hand if I didn’t get the splinter out. In contrast, I once cut my shin open very badly while rock climbing on a mild dose of mushrooms, and even though the laceration was very long and I could actually see the bone through the thin layer of skin, I did not panic. I was not seriously bleeding and I knew the wound could be easily sewn up at a hospital, and that all I had to do was stop the bleeding and wait a few hours until I could find someplace to get it stitched up. The graveness of my injury immediately grounded me in the reality of my situation, and brought me instantly back to sobriety, or near sobriety. Also, I had antibacterial ointment with me in the car that day, and was able to clean and treat the wound before bandaging it with a ripped t-shirt. Since I could control the bleeding and infection, I could relax and wait until the group I was with was sober enough to drive back to town and find an emergency room. In this situation, I was prepared enough to actively deal with the threat, making it easier to keep myself calm. Also, I knew that if I freaked out, the people I was with would start freaking out, and that would get us nowhere good. Because the situation was so real, panic was simply not an option.
In contrast to both of these situations, I once had a significant paranoid freak-out on LSD when I literally thought that the rock music coming from my stereo was laced with subliminal suicide messages. Now I know full well that hearing “masked messages” in otherwise innocuous media was a classic symptom of delusional psychosis, but I was sure I was hearing something real going on. The closer I listened to the music, the less literal and more subliminal it became, until all I could hear were disjointed and re-arranged snippets of music parsed back together with a totally distorted meaning, one that actively promoted nihilism and teen suicide. In retrospect I see how crazy it sounds, but I was picking up on the generic nihilistic rock-n-roll vibe and conflating it with the ‘70s rumors of Led Zeppelin using backwards-masking to place satanic messages in “Stairway to Heaven” and other hits. A whole paranoid scenario erupted in my brain: Record executives were making deals with Satan for fame and fortune in exchange for the souls of the innocent teens who buy the message. The details of this dastardly plot were just unfolding in my brain as I happened to look out the window and see a paramedic van circling the block, slowly. Why? Were they after me already? The paramedic van came around the block a second time, and I began to feel real panic. Because I had uncovered their plot they were somehow after me now, and were going to whisk me away to the loony-bin before I could tell anyone what I had discovered. Even speaking the details of such a crazy plot was an insidious trap guaranteed to get me sent to the nut-house. They had thought of everything, even how to deal with people who might expose them! What to do now?
Of course, the devious “They” of my paranoid fantasies were an invisible threat, they existed more in the machinations of my own mind then as an actual group of human beings in the real world. It is true that the music industry profits from selling nihilistic messages to the youth of America, and that some bands mask satanic messages in their music as a gimmick, but those two facts alone are not evidence of an industry-wide teen-suicide pact with Satan. However, the moment I began hearing “something strange” in the music under the influence of LSD, I connected all of these conspiratorial notions in my head and began to hear the satanic messages in the music for myself, and could see all the satanic, nihilistic, destructive, and suicidal imagery promoted alongside the music. I saw the rock music trend not as an artistic commentary on culture, but as a very real conspiracy to fuel Satan’s army of subservient souls with a very crafty marketing campaign. I thought I had blown the lid on something big, and by listening to the CD and parsing out the satanic messages I also had the proof. But when that paramedic van cruised down my street, the fear I felt was real. The scary end-result of every paranoid fantasy suddenly hit home. What if I was right? Who would believe me? Would they try to whack me? Who could I even tell without sounding completely nuts? The media was probably in on it. I was alone in my discovery, and the fact that I could not trust vocalizing my paranoid feelings — especially over the phone (they might be listening) — without seeming absolutely crazy was a trap itself. It locked me in the fear with no escape…
Best to get in bed and hide under the covers until it all goes away.
I got out of this particular paranoid trip like most people tripping people do: I was talked down by my very patient girlfriend who had rushed home from work because I sounded “freaked out” when I called her and told her I had something very important to tell her in person, and I couldn’t tell her over the phone, and that it couldn’t wait because it was very dangerous and people might be listening in on me already (Does that sound freaked out to you?). I bring this up because it is the classic paranoid delusion come to life. I constructed a grandiose scenario in my head based on real-world events but with no real evidence to back up the imaginary conjecture, other than hallucinatory ones. Even though I knew I was tripping and that I was probably making it all up, the nihilistic feeling coming through the music and the “masked” suicidal lyrics I was hearing made me doubt my own rationale, and the paranoid conspiracy became real to me at that moment because it felt real. I felt real fear.
On this particular trip I made the mistake of being alone and on too high a dose, so when I flipped I really flipped, and I had no ground to come back to. I panicked over a fabrication of my mind, because the fabrication could not be rationally dealt with; the depth of the conspiracy could be endless as long as it remained an invisible “Them” that I could not confront. Compared to the real-life danger of a 4-inch bone-deep laceration in my shin, the vaguely defined “Them” of the paranoid fantasy is much harder to cope with because “They” are invisible and out of your control, like the bacteria I feared under the splinter in my palm while hiking through the woods.
In the above examples the source of the anxiety is clear -- a splinter in the palm, or some menacing sounding rock music -- but anything can set off a psychedelic anxiety spiral. In group psychedelic trips anxiety is often generated by friction or communication errors between members. A common symptom of paranoia is to feel like everyone is watching you, scrutinizing you, judging you, or laughing at you behind your back. In a psychedelically charged social situation, any stray laugh, awkward glance, gesture, or innocent comment can be totally misinterpreted, misconstrued, and blown way out of proportion, and these social frictions typically get worse the longer they go unspoken. Letting the anxiety and paranoia fester under the surface is usually what causes communication errors to get distorted into full-blown freak-outs, and under the influence of psychedelics the mind can concoct the most elaborate paranoid conspiracy theories in a matter of seconds. Being able to get a rational grip on your emotions and then express them in words can become equally frustrating, thus communication “misfires” and unspoken feelings are a very real problem in group psychedelic sessions.
Traditionally, it would be the shaman’s job to recognize such group tensions and attempt to dissolve the friction or anxiety by getting everyone on the same wavelength, but for modern amateurs a great deal of angst-filled interpersonal freak-outs and psycho-trauma must be dealt with on the fly. This is precisely why groups that trip together often must quickly drop conventional social insecurities and build more secure bonds of trust and acceptance, often conceived of in the tribal or family paradigm. But beyond having a safe group environment in which to experiment, the key to dealing with the paranoia spiral is to first realize that this specific trap exists, and then devise a method or methods – in advance – to snap yourself out of it.
In an earlier section on “The Psychedelic Rules,” I talked a little bit about having a “grounding object” that you can return to when the psychedelic trip becomes too intense or begins to spiral out of control. Not all grounding strategies work: A friend once told me he made a recording of himself trying to talk himself down from a bad trip, but once he started tripping hard and needed the tape, he found it be full of useless garbage made by some idiot who didn’t know what the hell he was talking about. I have found from experience that the simpler the grounding object the better, something like a pleasant landscape photo, a rock, a bird’s feather, a sea shell, etc. Keep it mundane, natural objects are always good, and be sure not to choose anything with overtly occult or mythic symbols as those can often have the opposite of a grounding effect.
On the day of my hike in the woods, my grounding object was my wristwatch, and I knew exactly where the hands would be when I would be sober again, able to safely drive home and remove the deadly splinter from my palm. Being able to remember that the trip was temporary and that I had a timeline laid out in advance kept me from slipping into panic during my hike. Even in the peak of the trip, when I was out in the wilderness with nothing to keep me tethered to civilization or reality, I could always look at my watch and remember that there was a structured universe somewhere that I would return to, probably in time for dinner. Even if I couldn’t tell what time it was, I understood that everything would be back to normal later, and that I should just try to relax and enjoy myself while the universe unraveled into tiny singing trails of colored light. The watch forced me to be patient and keep myself occupied for the rest of the day, and when the trip was winding down the hands on my clock were exactly where they were supposed to be, and that made me feel much better about the whole splinter situation.
One final note about anxiety and paranoia spirals is that they are often dose dependent, and the higher the dose the more likely one is to feel dysphoria, anxiety, paranoia, etc. (Hobson). This does not mean that low doses are immune from such traps, just that it is much easier to snap out of them at lower doses. When “the fear” grasps onto you in higher dose sessions, the only thing to do is ride it out calmly in a safe place. Sit still, don’t talk or think, just breathe. The longer you sit still with nothing bad happening to you, the more you will realize that you are not in any immediate danger. There is a school of psychedelic thought that believes that sitting completely motionless and bringing the body to complete stillness is the way to get the best aspects of the psychedelic experience; the sensations of opening to the visionary self, raising consciousness, nurturing mindfulness, etc. There is a lot of truth to this, and it is very hard to feel anxiety while you are sitting quietly and meditating, even on psychedelics. Of course, quieting the body will almost always make the psychedelic trip itself stronger, and if your source of anxiety is that you want the trip to end (which is a common source of anxiety for newcomers), submitting entirely is not always the best solution. As always, people unfamiliar with the experience should have a sober sitter the first time they try a significant dose, or at least a close friend on speed-dial who they can count on to talk them down when things get hairy. This advice can hopefully prevent a lot of unnecessary freak-outs and unfortunate calls to 911.
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Tags : psychedelics hallucinogens emotions amygdala behavior
Posted on: 2006-07-27 22:32:28